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Health Column: Contrave, a new weight-loss drug that doesn’t do much

Phil Mohler, M.D.
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist

Contrived? Probably. But It’s called Contrave.

Add another competitor to the list of recently introduced weight-loss drugs. Contrave is a combination of two old drugs — bupropion, an antidepressant, to suppress appetite and naltrexone, a narcotic antagonist, to block food craving.

The pharmaceutical company studies that brought Contrave to market showed that, on average, patients lost only nine pounds over a period of 56 weeks. Half of the patients in both the Contrave group and in the placebo group dropped out before the study was completed. The high drop-out rate was related to 30 percent of the weight-loss pill takers developing nausea. The placebo groups in weight-loss trials often quit when they don’t lose weight.



Although the two drug components of Contrave have been around for some time, taking them in combination is of concern. Nausea is the most common side effect, but constipation, headache, dizziness and dry mouth occurred frequently. Increases in blood pressure and heart rate were also seen. Used in the same doses as for treatment of depression, bupropion has caused agitation, anxiety, sleeplessness and rarely seizures. As with other weight loss drugs, Contrave’s effectiveness in inducing weight loss waned after nine months.

My Take: At $7 a day, with minimal effect on weight loss and adverse effects that remain to be seen, Contrave joins my “Do Not Prescribe” list. None of this genre of drugs has ever shown any benefit in terms of long-term sustained weight loss. From the wacky use of HCG that really works when you pair it with a 500-calorie diet to fen-phen that was removed from the market because of its adverse lung and heart effects, there is no magic pill for weight loss. Instead think: three regular meals daily, control of portion sizes, lots of fruits and vegetables and exercise six days a week.



Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at nancyandphilmohler@gmail.com.


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